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Cattani L, Van Schoubroeck D, De Bruyn C, Ghesquière S, Deprest J. Body image and pelvic floor dysfunction in pregnancy and postpartum: A prospective one-year follow-up cohort study. BJOG 2024; 131:1420-1429. [PMID: 38628037 DOI: 10.1111/1471-0528.17820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 02/22/2024] [Accepted: 03/24/2024] [Indexed: 08/03/2024]
Abstract
OBJECTIVE To determine the prevalence of pelvic floor dysfunction (PFD) among pregnant women, their clustering and their association with body image disturbance (BID) up to 1 year postpartum. DESIGN Monocentric prospective cohort study. SETTING University Hospitals Leuven. POPULATION Pregnant women attending for pregnancy care, first assessed prior to 14 weeks of gestation and agreeing to follow-up until 1 year postpartum. METHODS Standardised questionnaires reporting on PFD and BID at 12-14 and 28-32 weeks of gestation, and again at 6-8 weeks and 1 year postpartum. We calculated the prevalence of PFD, how the cases clustered and how the cases correlated with BID using a linear mixed-model analysis. A minimum of 174 women with complete follow-up were required. MAIN OUTCOME MEASURES The questionnaires used were the International Consultation on Incontinence Questionnaire - Urinary Incontinence Short Form (ICIQ-UI SF), St. Mark's Incontinence Score (SMIS), Patient Assessment of Constipation Symptoms (PAC-SYM), Pelvic Organ Prolapse Distress Inventory (POPDI), Pelvic Organ Prolapse/Incontinence Sexual Questionnaire IUGA Revised (PISQ-IR) and the Body Image Disturbance Questionnaire (BIDQ). RESULTS Out of 208 women, 92.8% reported one or multiple symptoms of PFD at 28-32 weeks of gestation, dropping to 73.6% by 1 year postpartum. The most common symptoms were constipation (65.3% at 28-32 weeks of gestation and 42.8% at 1 year postpartum) and urinary incontinence (56.8% at 28-32 weeks of gestation and 35.1% at 1 year postpartum). After correcting for body mass index, parity and mode of delivery, the severity of BID was associated with the ICIQ-UI SF score (β = 0.016, range 0.007-0.024), the PAC-SYM score (β = 0.006, range 0.002-0.011) and the POPDI score (β = 0.009, range 0.005-0.012), but not with the SMIS score (β = 0.015, range -0.001 to 0.031) or the PISQ-IR score, in sexually active women. CONCLUSIONS Urinary incontinence, constipation and symptoms of prolapse have a measurable impact on BID.
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Affiliation(s)
- Laura Cattani
- Department of Development and Regeneration, Cluster Urogenital Surgery, Biomedical Sciences, KU Leuven, Leuven, Belgium
- Department of Gynaecology and Obstetrics, UZ Leuven, Leuven, Belgium
| | - Dominique Van Schoubroeck
- Department of Development and Regeneration, Cluster Urogenital Surgery, Biomedical Sciences, KU Leuven, Leuven, Belgium
- Department of Gynaecology and Obstetrics, UZ Leuven, Leuven, Belgium
| | - Christine De Bruyn
- Department of Gynaecology and Obstetrics, UZ Leuven, Leuven, Belgium
- Department of Gynaecology and Obstetrics, UZ Antwerp, Edegem, Belgium
| | - Sophie Ghesquière
- Department of Gynaecology and Obstetrics, AZ Groeninge, Kortrijk, Belgium
| | - Jan Deprest
- Department of Development and Regeneration, Cluster Urogenital Surgery, Biomedical Sciences, KU Leuven, Leuven, Belgium
- Department of Gynaecology and Obstetrics, UZ Leuven, Leuven, Belgium
- Research Department of Maternal Fetal Medicine, Institute for Women's Health, University College London, London, UK
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Wang J, Ye H, Zhang C, Zhang A. Association of diarrhea or constipation with urinary incontinence in adults: A cross-sectional analysis of the National Health and Nutrition Examination Survey. Neurourol Urodyn 2024; 43:1674-1685. [PMID: 38693849 DOI: 10.1002/nau.25480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 04/05/2024] [Accepted: 04/11/2024] [Indexed: 05/03/2024]
Abstract
AIMS This study aimed to investigate the association between diarrhea or constipation and urinary incontinence (UI) in adults. METHODS Data from the National Health and Nutrition Examination Survey for 2009-2010 was used to include 4686 adults aged 20 and over in the analysis. Stress urinary incontinence (SUI) and urgency urinary incontinence (UUI) were used as outcome variables, with diarrhea and constipation as exposure factors. We first compared the baseline characteristics of those with and without SUI, as well as those with and without UUI. The impact of diarrhea or constipation on SUI and UUI was assessed using multivariate logistic regression models. To ensure the stability of the results, subgroup and stratified analyses were conducted. RESULTS The prevalence rates of UUI and SUI were 22.49% and 23.39%, respectively. Adjusted multivariate logistic regression analysis revealed that the risk of UUI was increased by either diarrhea (OR 1.66, 95% CI 1.36-2.04) or constipation (OR 1.42, 95% CI 1.11-1.83). The risk of SUI was also elevated by either diarrhea (OR 1.36, 95% CI 1.11-1.67) or constipation (OR 1.32, 95% CI 1.06-1.63). Subgroup analysis revealed no significant differences in the interaction tests between constipation or diarrhea and UI. CONCLUSIONS This study found that both constipation and diarrhea increase the risk of UUI and SUI.
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Affiliation(s)
- Junwei Wang
- Department of Urology, Wenling Hospital Affiliated to Wenzhou Medical University (The First People's Hospital of Wenling), Taizhou, Zhejiang, China
| | - Haibo Ye
- Department of Urology, Wenling Hospital Affiliated to Wenzhou Medical University (The First People's Hospital of Wenling), Taizhou, Zhejiang, China
| | - Cunming Zhang
- Department of Urology, Wenling Hospital Affiliated to Wenzhou Medical University (The First People's Hospital of Wenling), Taizhou, Zhejiang, China
| | - Aiwei Zhang
- Department of Ultrasound, Wenling Hospital Affiliated to Wenzhou Medical University (The First People's Hospital of Wenling), Taizhou, Zhejiang, China
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Hellman-Bronstein AT, Luukkaala TH, Ala-Nissilä SS, Nuotio MS. Associated factors of stress, urgency, and mixed urinary incontinence in a geriatric outpatient assessment of older women with hip fracture. Eur Geriatr Med 2024; 15:861-869. [PMID: 38802641 PMCID: PMC11329388 DOI: 10.1007/s41999-024-00997-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 05/14/2024] [Indexed: 05/29/2024]
Abstract
PURPOSE Urinary incontinence (UI) is known to be common among older female hip fracture patients. Little is known about different subtypes of UI among these patients. Our aim was to identify factors associated with subtypes of UI in a cross-sectional design. METHODS 1,675 female patients aged ≥ 65 and treated for their first hip fracture in Seinäjoki Central Hospital, Finland, during 2007-2019, were included in a prospective cohort study. Of these, 1,106 underwent comprehensive geriatric assessment (CGA), including questions on continence, at our geriatric outpatient clinic 6 month post-fracture. A multivariable-adjusted multinomial logistic regression model was used to examine factors associated with UI subtypes. RESULTS Of the 779 patients included, 360 (46%) were continent and 419 (54%) had UI 6-month post-fracture. Of the women with UI, 117 (28%) had stress UI, 183 (44%) had urgency UI and 119 (28%) had mixed UI, respectively. Mean age of the patients was 82 ± 6,91. In multivariable analysis, depressive mood and poor mobility and functional ability were independently associated with stress UI. Fecal incontinence (FI) and Body Mass Index (BMI) over 28 were independently associated with urgency UI. Mixed UI shared the aforementioned factors with stress and urgency UI and was independently associated with constipation. CONCLUSIONS Mixed UI was associated with most factors, of which depressive mood and impaired mobility and poor functional ability were shared with stress UI, and FI and higher BMI with urgency UI. CGA is key in assessing UI in older hip fracture patients, regardless of subtype.
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Affiliation(s)
- Aino T Hellman-Bronstein
- Department of Geriatric Medicine, Turku University Hospital and University of Turku, Turku, Finland.
| | - Tiina H Luukkaala
- Research, Development and Innovation Center, Tampere University Hospital, Tampere, Finland
- Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Seija S Ala-Nissilä
- Department of Obstetrics and Gynecology, Turku University Hospital and University of Turku, Turku, Finland
| | - Maria S Nuotio
- Department of Geriatric Medicine, Turku University Hospital and University of Turku, Turku, Finland
- Department of Geriatric Medicine, Seinäjoki Central Hospital, Seinäjoki, Finland
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Najafi Z, Morowatisharifabad MA, Jambarsang S, Rezaeipandari H, Hemayati R. Urinary incontinence and related quality of life among elderly women in Tabas, South Khorasan, Iran. BMC Urol 2022; 22:214. [PMID: 36587231 PMCID: PMC9805688 DOI: 10.1186/s12894-022-01171-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 12/27/2022] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Urinary incontinence (UI) is one of the most common problems in old age that is often seen in women, which causes not only physical problems but also psychological, social, economic problems and poor quality of life. The aim of the present study was to evaluate the UI and related quality of life (QoL) in elderly women. METHODS This cross-sectional study enrolled 369 women over 60 years old and living in Tabas city, Iran who were selected by cluster random sampling method. The instruments included the International Consultation on Incontinence Questionnaire-Short Form, the International Consultation on Incontinence Questionnaire Urinary Incontinence Quality of Life Module, and a demographic questionnaire. Data analysis was carried out using independent t-test, chi-square, and logistic regression in SPSS software. RESULTS The UI prevalence among participants was 24.9% and stress urinary incontinence was the most common type (40.2% of all elderly patients). The mean UI-related QoL score was 38.04 ± 11.67 from the score range of 22-76. There was a significant positive correlation between UI-related QoL score and UI score (r = 0.585, p < 0.001). Age, body mass index (BMI), constipation, history of cesarean section, hypertension, and the use of angiotensin receptor blockers are factors increasing the odds of having UI in this study population. CONCLUSION Aging, some chronic diseases, high BMI, and the use of some drugs are related to UI prevalence. Also, it is associated with lower QOL among elderly women. Designing appropriate intervention programs, controlling chronic diseases, training in the proper use of drugs, and also some physical exercises can be effective in controlling and improving this common syndrome of old age and promoting their QoL.
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Affiliation(s)
- Zahra Najafi
- grid.412505.70000 0004 0612 5912International Campus, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohammad Ali Morowatisharifabad
- grid.412505.70000 0004 0612 5912Elderly Health Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran ,grid.412505.70000 0004 0612 5912Department of Aging Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Sara Jambarsang
- grid.412505.70000 0004 0612 5912Center for Healthcare Data Modeling, Departments of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Hassan Rezaeipandari
- grid.412505.70000 0004 0612 5912Elderly Health Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran ,grid.412505.70000 0004 0612 5912Department of Aging Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Roya Hemayati
- grid.412505.70000 0004 0612 5912Department of Internal Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Factors associated with urinary and double incontinence in a geriatric post-hip fracture assessment in older women. Aging Clin Exp Res 2022; 34:1407-1418. [PMID: 34984652 PMCID: PMC9151507 DOI: 10.1007/s40520-021-02046-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 12/02/2021] [Indexed: 11/01/2022]
Abstract
BACKGROUND Incontinence and hip fractures are common in older people, especially women, and associated with multiple adverse effects. Incontinence is a risk factor for falls. AIMS We aimed to investigate the prevalence of urinary (UI) and double incontinence (DI, concurrent UI and faecal incontinence), and to identify factors associated with UI and DI 6 months post-fracture. METHODS A prospective real-life cohort study was conducted consisting of 910 women aged ≥ 65 who were treated for their first hip fracture in Seinäjoki Central Hospital, Finland, between May 2008 and April 2018. Continence status was elicited at baseline and 6 months postoperatively at our geriatric outpatient clinic where all participants underwent a multidisciplinary comprehensive geriatric assessment (CGA) consisting of an evaluation of cognition, nutrition, mood, mobility, and functional ability. RESULTS At baseline, 47% of the patients were continent, 45% had UI and 8% had DI, and at follow up, 38%, 52%, and 11%, respectively. The mean age of the patients was 82.7 ± 6.8. Both UI and DI were associated with functional disability and other factors related to frailty. The associations were particularly prominent for patients with DI who also had the worst performance in the domains of CGA. We identified several modifiable risk factors: depressive mood (odds ratio [OR] 1.81; 95% confidence interval [CI] 1.16-2.84) and constipation (OR 1.48, 95% CI 1.02-2.13) associated with UI and, late removal of urinary catheter (OR 2.33, 95% CI 1.31-4.14), impaired mobility (OR 2.08, 95% CI 1.05-4.15), and poor nutrition (OR 2.31, 95% CI 1.11-4.79) associated with DI. CONCLUSIONS This study demonstrates a high prevalence of UI and DI in older women with hip fracture and modifiable risk factors, which should be targeted in orthogeriatric management and secondary falls prevention. Patients with DI were found to be an especially vulnerable group.
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Wallin E, Falconer H, Carlson J, Haglund C, Koskela LR, Rådestad AF. Objective and subjective assessment of bladder function after robot-assisted laparoscopic radical hysterectomy for early stage cervical cancer. J Minim Invasive Gynecol 2022; 29:1075-1082. [PMID: 35654357 DOI: 10.1016/j.jmig.2022.05.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 05/23/2022] [Accepted: 05/25/2022] [Indexed: 11/16/2022]
Abstract
STUDY OBJECTIVE To examine whether objective bladder function following robot-assisted radical hysterectomy (RRH) for early-stage cervical cancer is correlated with subjective patient-reported outcomes as well as quality of life during the first year after RRH. DESIGN Prospective observational study SETTING: Karolinska University Hospital, Sweden PATIENTS: Women with early stage cervical cancer (FIGO stage IA2-IB1) between July 2017 and May 2019 were assessed for eligibility. INTERVENTIONS Robotic radical hysterectomy (RRH) MEASUREMENTS AND MAIN RESULTS: Subjective bladder function was evaluated with the Female Lower Urinary Tract Symptoms and Urinary Incontinence Quality of Life modules of the International Consultation on Incontinence Questionnaire. Objective urinary function was characterized with urodynamic tests and the nerves ablated at RRH were quantified by using immunohistochemical staining of biopsies from the resected paracervix, vesico-uterine and sacro-uterine ligaments. Twenty-seven women were included for analysis at baseline, two weeks, three months and 12 months after surgery. RRH caused hypotonia of the urinary bladder (p<.05). Patient reported outcomes of voiding and filling dysfunction were most significant 2 weeks after surgery (p<.05) but for most of the women bladder function recovered within 3 months. No correlations were found with either subjective nor objective urinary function and the number of ablated nerves. CONCLUSION For the majority of women, objective and subjective urinary bladder dysfunction recovered within 3 months after RRH. The absence of correlation between functional outcomes and ablated autonomous nerves suggest that other underlying causes play a significant role. Early detection of bladder overextension after RRH is paramount and the role of postoperative bladder catherization needs further investigation.
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Affiliation(s)
- Emelie Wallin
- Department of Women´s and Children´s Health and Division of Obstetrics and Gynecology, Karolinska Institutet, Stockholm, Sweden and Department of Pelvic Cancer, Karolinska University Hospital, Stockholm, Sweden.
| | - Henrik Falconer
- Department of Women´s and Children´s Health and Division of Obstetrics and Gynecology, Karolinska Institutet, Stockholm, Sweden and Department of Pelvic Cancer, Karolinska University Hospital, Stockholm, Sweden
| | - Joseph Carlson
- Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Cecilia Haglund
- Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Lotta Renström Koskela
- Department of Molecular Medicine and Surgery, Karolinska Institutet, and Department of Pelvic Cancer, Karolinska University Hospital, Stockholm, Sweden
| | - Angelique Flöter Rådestad
- Department of Women´s and Children´s Health and Division of Obstetrics and Gynecology, Karolinska Institutet, Stockholm, Sweden and Department of Breast, Endocrine Tumours and Sarcoma, Karolinska University Hospital, Stockholm, Sweden
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Hung SF, Yii SC, Chung SD. Re: Zhiwen Chen, Peng He, Xiaozhou Zhou, et al. Preliminary Functional Outcome Following Robotic Intracorporeal Orthotopic Ileal Neobladder Suspension with Round Ligaments in Women with Bladder Cancer. Eur Urol. In press. https://doi.org/10.1016/j.eururo.2021.11.012. Eur Urol 2022; 81:e118. [PMID: 35151516 DOI: 10.1016/j.eururo.2021.12.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 12/29/2021] [Indexed: 11/04/2022]
Affiliation(s)
- Shun-Fa Hung
- Division of Urology, Department of Surgry, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Shyi-Chun Yii
- Division of Urology, Department of Surgry, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Shiu-Dong Chung
- Division of Urology, Department of Surgry, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
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Scime NV, Hetherington E, Metcalfe A, Chaput KH, Dumanski SM, Seow CH, Brennand EA. Association between chronic conditions and urinary incontinence in females: a cross-sectional study using national survey data. CMAJ Open 2022; 10:E296-E303. [PMID: 35383034 PMCID: PMC9259416 DOI: 10.9778/cmajo.20210147] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Urinary incontinence affects up to half of women, yet few speak to their health care provider about or receive treatment for the condition. To aid with identifying subpopulations at risk for urinary incontinence, we examined the associations between 10 chronic health conditions and urinary incontinence among Canadian adult females. METHODS We conducted a cross-sectional analysis of survey data from the Canadian Community Health Survey (2013-2014) involving female respondents aged 25 years or older living in a private dwelling. Presence of chronic conditions and urinary incontinence were measured by self-report. We used logistic regression modelling with sampling weights, controlling for age, income, ethnicity, body mass index and smoking. Multiple imputation and probabilistic bias analysis were used to address missing covariate data and unmeasured confounding from parity. RESULTS Our analysis included 60 186 respondents representing more than 12 million Canadian females, of whom 45.8% (95% confidence interval [CI] 45.0%-46.6%) reported at least 1 chronic condition. Chronic conditions were associated with more than twice the odds of urinary incontinence (adjusted odds ratio [OR] 2.42, 95% CI 2.02-2.89). Associations were largest for bowel disorders (adjusted OR 2.92, 95% CI 2.44-3.49); modest for chronic obstructive pulmonary disease (adjusted OR 2.00, 95% CI 1.63-2.45), asthma (adjusted OR 1.82, 95% CI 1.52-2.19), arthritis (adjusted OR 1.98, 95% CI 1.74-2.24) and heart disease (adjusted OR 1.73, 95% CI 1.48-2.02); and smallest for diabetes (adjusted OR 1.20, 95% CI 1.02-1.41) and high blood pressure (adjusted OR 1.27, 95% CI 1.12-1.44). Results slightly attenuated but did not substantively change after imputation and bias analysis. INTERPRETATION We found that chronic conditions are associated with significantly higher odds of comorbid urinary incontinence among Canadian adult females, which is consistent with previous research. Our findings support routine inquiry regarding urinary incontinence symptoms among women accessing health care for chronic conditions.
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Affiliation(s)
- Natalie V Scime
- Department of Community Health Sciences (Scime, Metcalfe, Seow, Brennand), University of Calgary, Calgary, Alta.; Department of Epidemiology, Biostatistics and Occupational Health (Hetherington), McGill University, Montréal, Que.; Department of Obstetrics and Gynecology (Metcalfe, Chaput, Brennand), University of Calgary; Division of Nephrology (Dumanski), Division of Gastroenterology & Hepatology (Seow), Department of Medicine, University of Calgary, Calgary, Alta
| | - Erin Hetherington
- Department of Community Health Sciences (Scime, Metcalfe, Seow, Brennand), University of Calgary, Calgary, Alta.; Department of Epidemiology, Biostatistics and Occupational Health (Hetherington), McGill University, Montréal, Que.; Department of Obstetrics and Gynecology (Metcalfe, Chaput, Brennand), University of Calgary; Division of Nephrology (Dumanski), Division of Gastroenterology & Hepatology (Seow), Department of Medicine, University of Calgary, Calgary, Alta
| | - Amy Metcalfe
- Department of Community Health Sciences (Scime, Metcalfe, Seow, Brennand), University of Calgary, Calgary, Alta.; Department of Epidemiology, Biostatistics and Occupational Health (Hetherington), McGill University, Montréal, Que.; Department of Obstetrics and Gynecology (Metcalfe, Chaput, Brennand), University of Calgary; Division of Nephrology (Dumanski), Division of Gastroenterology & Hepatology (Seow), Department of Medicine, University of Calgary, Calgary, Alta
| | - Kathleen H Chaput
- Department of Community Health Sciences (Scime, Metcalfe, Seow, Brennand), University of Calgary, Calgary, Alta.; Department of Epidemiology, Biostatistics and Occupational Health (Hetherington), McGill University, Montréal, Que.; Department of Obstetrics and Gynecology (Metcalfe, Chaput, Brennand), University of Calgary; Division of Nephrology (Dumanski), Division of Gastroenterology & Hepatology (Seow), Department of Medicine, University of Calgary, Calgary, Alta
| | - Sandra M Dumanski
- Department of Community Health Sciences (Scime, Metcalfe, Seow, Brennand), University of Calgary, Calgary, Alta.; Department of Epidemiology, Biostatistics and Occupational Health (Hetherington), McGill University, Montréal, Que.; Department of Obstetrics and Gynecology (Metcalfe, Chaput, Brennand), University of Calgary; Division of Nephrology (Dumanski), Division of Gastroenterology & Hepatology (Seow), Department of Medicine, University of Calgary, Calgary, Alta
| | - Cynthia H Seow
- Department of Community Health Sciences (Scime, Metcalfe, Seow, Brennand), University of Calgary, Calgary, Alta.; Department of Epidemiology, Biostatistics and Occupational Health (Hetherington), McGill University, Montréal, Que.; Department of Obstetrics and Gynecology (Metcalfe, Chaput, Brennand), University of Calgary; Division of Nephrology (Dumanski), Division of Gastroenterology & Hepatology (Seow), Department of Medicine, University of Calgary, Calgary, Alta
| | - Erin A Brennand
- Department of Community Health Sciences (Scime, Metcalfe, Seow, Brennand), University of Calgary, Calgary, Alta.; Department of Epidemiology, Biostatistics and Occupational Health (Hetherington), McGill University, Montréal, Que.; Department of Obstetrics and Gynecology (Metcalfe, Chaput, Brennand), University of Calgary; Division of Nephrology (Dumanski), Division of Gastroenterology & Hepatology (Seow), Department of Medicine, University of Calgary, Calgary, Alta.
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Prevalence and Risk Factors of Urinary Incontinence Among Elderly Adults in Rural China: A Cross-Sectional Survey. J Wound Ostomy Continence Nurs 2022; 49:78-86. [PMID: 35040817 DOI: 10.1097/won.0000000000000829] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The purpose of this study was to explore the prevalence of urinary incontinence (UI) and several subtypes: (stress, urge, and mixed UI) and the influence of multiple factors on the likelihood of UI. DESIGN Epidemiological study based on cross-sectional data collection. SUBJECTS AND SETTING The sample comprised 1279 inhabitants 65 years and older residing in 10 villages randomly selected from the Shanxi province, located in North China. METHODS The presence and types of UI were assessed using the International Consultation of Incontinence Questionnaire-Short Form. Sociodemographic parameters were also recorded, along with data on lifestyle, bowel function, and medical conditions. The Activity of Daily Living Scale and Mini-Mental State Examination instruments were used to evaluate physical and cognitive functions, respectively. A multivariate logistic regression model with the backward method was employed to identify factors associated with UI. RESULTS The prevalence of any UI among the rural Chinese elderly 65 years and older was 46.8%, with a female predominance (56.3% in females vs 35.0% in males). The most common incontinence subtype in women was mixed UI (n = 170, 24.0%), followed by stress UI (n = 131, 18.5%) and urge UI (n = 97, 13.7%). The most prevalent form of UI in males was urge UI (n = 190, 33.2%), followed by stress UI (n = 5, 0.9%) and mixed UI (n = 5, 0.9%). Less than one quarter of respondents (17%, n = 102) of participants with UI had consulted a doctor. Multivariate analysis found that poorer physical function, poor quality of sleep, and fecal incontinence were common factors associated with UI in both women and men. In women, higher body mass index and constipation were also independent correlates, as were poor vision and heart disease in men. Poorer physical function was associated with all UI subtypes. For female stress UI, poorer cognitive status, tea drinking, and hypertension also emerged as independent risk factors. Heart disease was an independent risk factor in both female and male urge UI; as was consumption of a non-plant-based diet for female mixed and urge UI; nonfarmer and traumatic brain injury for female urge UI; and poor vision and fecal incontinence in male urge UI. CONCLUSIONS Chinese rural citizens showed a high UI prevalence, but only a small proportion had consulted a health care provider. Physical function decline was the most important contributor to UI among participants. Individualized intervention programs targeting modifiable risk factors among high-risk populations should be developed.
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Role of Pelvic Organ Crosstalk in Dysfunction of the Bowel and Bladder. CURRENT BLADDER DYSFUNCTION REPORTS 2022. [DOI: 10.1007/s11884-022-00645-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Mariani A, Gambazza S, Carta F, Ambrogi F, Brivio A, Bulfamante AM, Daccò V, Bassotti G, Colombo C. Prevalence and factors associated with urinary incontinence in females with cystic fibrosis: An Italian single-center cross-sectional analysis. Pediatr Pulmonol 2022; 57:132-141. [PMID: 34636479 DOI: 10.1002/ppul.25723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/29/2021] [Accepted: 10/10/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Individuals with cystic fibrosis (CF) are deemed to have a higher risk of developing urinary incontinence (UI), likely due to repeated increasing pressure on the pelvic floor. We aimed to determine the prevalence of female UI in a large CF referral center, and to assess the association between UI and severity of CF disease. METHODS We consecutively recruited female patients regularly attending our CF center, aged ≥6 years and with a confirmed diagnosis of CF. Prevalence, severity, and impact of UI were assessed by administering two validated questionnaires. Relationship between variables was evaluated by means of multiple correspondence analysis, whereas a logistic model was fitted to capture the statistical association between UI and independent variables. RESULTS UI was present in 51/153 (33%, 95% confidence interval [CI]: 26%-41%) females. Among children and adolescents, the prevalence was 12/82 (15%, 95% CI: 8%-25%) whereas among adults was 39/71 (55%, 95% CI: 43%-67%). The only explanatory variable associated with UI was age, with children presenting the lowest risk (odds ratio, 0.32; 95% CI: 0.05-0.93). Females presenting low or high nutritional status show higher profile risk of having UI. CONCLUSIONS Stress UI is a common complication in females with CF since childhood. Although it frequently occurs in older patients with a more severe phenotype, much attention should be paid to adults and to their nutritional status.
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Affiliation(s)
- Alessandra Mariani
- Cystic Fibrosis Centre, Fondazione IRCCS Ca', Granda Ospedale Maggiore Policlinico, Milano, Italy.,Direzione delle Professioni Sanitarie, Fondazione IRCCS Ca', Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Simone Gambazza
- Direzione delle Professioni Sanitarie, Fondazione IRCCS Ca', Granda Ospedale Maggiore Policlinico, Milano, Italy.,Department of Clinical Sciences and Community Health, University of Milan, Milano, Italy
| | - Federica Carta
- Cystic Fibrosis Centre, Fondazione IRCCS Ca', Granda Ospedale Maggiore Policlinico, Milano, Italy.,Direzione delle Professioni Sanitarie, Fondazione IRCCS Ca', Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Federico Ambrogi
- Department of Clinical Sciences and Community Health, University of Milan, Milano, Italy
| | - Anna Brivio
- Cystic Fibrosis Centre, Fondazione IRCCS Ca', Granda Ospedale Maggiore Policlinico, Milano, Italy.,Direzione delle Professioni Sanitarie, Fondazione IRCCS Ca', Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Anna M Bulfamante
- Cystic Fibrosis Centre, Fondazione IRCCS Ca', Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Valeria Daccò
- Cystic Fibrosis Centre, Fondazione IRCCS Ca', Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Giacomo Bassotti
- Cystic Fibrosis Centre, Fondazione IRCCS Ca', Granda Ospedale Maggiore Policlinico, Milano, Italy.,Direzione delle Professioni Sanitarie, Fondazione IRCCS Ca', Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Carla Colombo
- Cystic Fibrosis Centre, Fondazione IRCCS Ca', Granda Ospedale Maggiore Policlinico, Milano, Italy.,Department of Pathophysiology and Transplantation, University of Milan, Milano, Italy
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Tai H, Liu S, Wang H, Tan H. Determinants of Urinary Incontinence and Subtypes Among the Elderly in Nursing Homes. Front Public Health 2021; 9:788642. [PMID: 34938714 PMCID: PMC8685234 DOI: 10.3389/fpubh.2021.788642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Accepted: 11/15/2021] [Indexed: 11/13/2022] Open
Abstract
Urinary incontinence (UI) is a common problem among older adults. This study investigated the prevalence of UI in nursing home residents aged ≥75 years in China and examined potential risk factors associated with UI and its subtypes. Data were collected during face-to-face interviews using a general questionnaire, the International Consultation Incontinence Questionnaire Short-Form, and the Barthel Index. A total of 551 participants aged ≥75 years residing in Changsha city were enrolled from June to December 2018. The UI prevalence rate among nursing home residents aged ≥75 years was 24.3%. The most frequent subtype was mixed (M) UI (38.1%), followed by urge (U) UI (35.1%), stress (S) UI (11.9%), and other types (14.9%). In terms of severity, 57.5% had moderate UI, while 35.1% had mild and 7.5% had severe UI. Constipation, immobility, wheelchair use, cardiovascular disease (CVD), and pelvic or spinal surgery were significant risk factors for UI. Participants with a history of surgery had higher risks of SUI (odds ratio [OR] = 4.87, 95% confidence interval [CI]: 1.55–15.30) and UUI (OR = 1.97, 95% CI: 1.05–3.71), those who were immobile or used a wheelchair had higher rates of MUI (OR = 11.07, 95% CI: 4.19–29.28; OR = 3.36, 95% CI: 1.16–9.78) and other UI types (OR = 7.89, 95% CI: 1.99–31.30; OR = 14.90, 95% CI: 4.88–45.50), those with CVD had a higher rate of UUI (OR = 2.25, 95% CI: 1.17–4.34), and those with diabetes had a higher risk of UUI (OR = 2.250, 95% CI: 1.14–4.44). Use of oral antithrombotic agents increased UUI risk (OR = 4.98, 95% CI: 2.10–11.85) whereas sedative hypnotic drug use was associated with a higher risk of MUI (OR = 3.62, 95% CI: 1.25–10.45). Each UI subtype has distinct risk factors, and elderly residents of nursing homes with a history of CVD and pelvic or spinal surgery who experience constipation should be closely monitored. Reducing time spent in bed and engaging in active rehabilitation including walking and muscle strengthening may aid in UI prevention and treatment.
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Affiliation(s)
- Hongyan Tai
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Shunying Liu
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Haiqin Wang
- Geriatric Department, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Hongzhuan Tan
- Xiangya School of Public Health, Central South University, Changsha, China
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13
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Hüsch T, Reitz A, Schneidewind L, Kranz J. [32/f with lower urinary tract symptoms : Preparation for the medical specialist examination: part 19]. Urologe A 2021; 61:56-62. [PMID: 34613444 DOI: 10.1007/s00120-021-01655-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2021] [Indexed: 10/20/2022]
Affiliation(s)
- Tanja Hüsch
- Klinik und Poliklinik für Urologie und Kinderurologie, Universitätsmedizin der Johannes-Gutenberg-Universität Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland.
| | - André Reitz
- Kontinenz Zentrum Hirslanden, Zürich, Schweiz
| | - Laila Schneidewind
- Urologische Klinik und Poliklinik, Universitätsmedizin Rostock, Rostock, Deutschland
| | - Jennifer Kranz
- Klinik und Poliklinik für Urologie, Uniklinik RWTH Aachen, Aachen, Deutschland.,Universitätsklinik und Poliklinik für Urologie, Universitätsklinikum Halle (Saale), Halle (Saale), Deutschland
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An Evidenced-based Approach to Stress Urinary Incontinence in Women: What's New? Clin Obstet Gynecol 2021; 64:287-296. [PMID: 33904836 DOI: 10.1097/grf.0000000000000616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Stress urinary incontinence is a common condition in women potentially affecting women of any age including young women who have not yet completed childbearing. It is important to consider the impact on quality of life and offer treatment to those experiencing bother. There are several effective nonsurgical treatments for women before considering more invasive or definitive intervention. There is good data on lifestyle and behavioral changes which are often first-line recommendations. Data is also strong for pelvic muscle training and strengthening. Pessary supportive devices also play a role. Additional options also exist for limited indications.
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Lenger SM, Chu CM, Ghetti C, Hardi AC, Lai HH, Pakpahan R, Lowder JL, Sutcliffe S. Adult female urinary incontinence guidelines: a systematic review of evaluation guidelines across clinical specialties. Int Urogynecol J 2021; 32:2671-2691. [PMID: 33881602 DOI: 10.1007/s00192-021-04777-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 03/24/2021] [Indexed: 11/25/2022]
Abstract
INTRODUCTION AND HYPOTHESIS To systematically review evaluation guidelines of uncomplicated urinary incontinence (UI) in community-dwelling adult women to assess guidance available to the full range of providers treating UI. METHODS Systematic literature search of eight bibliographic databases. We included UI evaluation guidelines written for medical providers in English after January 1, 2008. EXCLUSION CRITERIA guidelines for children, men, institutionalized women, peripartum- and neurologic-related UI. A quantitative scoring system included assessed components and associated recommendation level and clarity. RESULTS Twenty-two guidelines met the criteria. All guidelines included: history taking, UI characterization, physical examination (PE) performance, urinalysis, and post-void residual volume assessment. At least 75% included medical and surgical history assessment, other disease process exclusion, medication review, impact on quality of life ascertainment, observing stress UI, mental status assessment, performing a pelvic examination, urine culture, bladder diary, and limiting more invasive diagnostics procedures. Fifty to 75% included other important evaluation components (i.e., assessing obstetric history, bowel symptoms, fluid intake, patient expectations/preferences/values, obesity, physical functioning/mobility, other PE [abdominal, rectal, pelvic muscle, and neurologic], urethral hypermobility, and pad testing. Less than 50% of guidelines included discussing patient treatment goals. Guidelines varied in level of detail and clarity, with several instances of unclear or inconsistent recommendations within the same guideline and evaluation components identified only by inference from treatment recommendations. Non-specialty guidelines reported fewer components with a lesser degree of clarity, but this difference was not statistically significant (p = 0.20). CONCLUSIONS UI evaluation guidelines varied in level of comprehensiveness, detail, and clarity. This variability may lead to inconsistent evaluations in the work-up of UI, contributing to missed opportunities for individualized care.
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Affiliation(s)
- Stacy M Lenger
- Department of Obstetrics, Gynecology, and Women's Health, Division of Female Pelvic Medicine and Reconstructive Surgery, The University of Louisville School of Medicine, Louisville, KY, USA.,Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, Washington University School of Medicine, St. Louis Center for Outpatient Health, 9th floor, Campus, Box 8064, St. Louis, MO, 63110, USA
| | - Christine M Chu
- Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, Washington University School of Medicine, St. Louis Center for Outpatient Health, 9th floor, Campus, Box 8064, St. Louis, MO, 63110, USA
| | - Chiara Ghetti
- Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, Washington University School of Medicine, St. Louis Center for Outpatient Health, 9th floor, Campus, Box 8064, St. Louis, MO, 63110, USA
| | - Angela C Hardi
- Washington University School of Medicine, Becker Medical Library, St. Louis, MO, USA
| | - H Henry Lai
- Department of Surgery, Division of Urologic Surgery, Washington University School of Medicine, St. Louis, MO, USA
| | - Ratna Pakpahan
- Department of Surgery, Division of Public Health Sciences, Washington University School of Medicine, St. Louis, MO, USA
| | - Jerry L Lowder
- Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, Washington University School of Medicine, St. Louis Center for Outpatient Health, 9th floor, Campus, Box 8064, St. Louis, MO, 63110, USA.
| | - Siobhan Sutcliffe
- Department of Surgery, Division of Public Health Sciences, Washington University School of Medicine, St. Louis, MO, USA
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Bovbjerg ML. Current Resources for Evidence-Based Practice, September 2020. J Obstet Gynecol Neonatal Nurs 2020; 49:487-499. [PMID: 32805207 PMCID: PMC7428455 DOI: 10.1016/j.jogn.2020.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
An extensive review of new resources to support the provision of evidence-based care for women and infants. The current column includes a discussion of “spin” in scientific reporting and its effect on summaries and syntheses of the literature and commentaries on reviews about early versus late amniotomy as part of labor induction protocols and the economic burden associated with maternal morbidity.
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Salgado-Maldonado A, Ramírez-Santana M. Urinary incontinence in Chilean women: A prevalence study of the health profile and associated factors. Medwave 2020. [DOI: 10.5867/medwave.2020.06.7977] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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